Grant Review Committee
Nomination Form
NOMINATOR DETAILS
The nominator is the person submitting the nomination form
Nominator Full Name
*
Title/Honorific (E.g. Dr/Ms/Mr)
First Name
Last Name
Nominator Email
*
example@example.com
Nominator's Organisation/Institution
*
Nominator's role/position within their Organisation
*
AASSREC Member Organisation (if applicable)
If the nominator is affiliated with an AASSREC Member Organisation, please provide the name of the AASSREC member.
NOMINEE DETAILS
Please provide details of the person being nominated for the Grant Review Committee.
Nominee's Full Name
*
Title/Honorific (E.g. Dr/Ms/Mr)
First Name
Last Name
Nominee Gender
*
Please Select
Male
Female
Non-Binary
Unspecified/Indeterminate/Prefer not to say
Nominee Email
*
example@example.com
Nominee's Country of Residence
*
Nominee's Nationality
*
Nominee's Organisation/Institution
*
e.g. Place of work
Nominee's Current Professional Position
*
Nominee's Discipline/Area of Expertise
*
JUSTIFICATION
*
Please provide an overview statement (maximum 300 words) from the nominee, outlining the nominee's interest in the role, and the justification for the nomination (e.g. the nominee’s professional experience, qualifications, core strengths, and the value the nominee will bring to the Grant Review Committee).
Nominee's CV
*
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Please upload the Nominee's CV (pdf format)
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DECLARATION OF UNDERSTANDING
Nominees need to have agreed to their nomination before it is submitted.
Declaration of Understanding (declared by the nominator on behalf of the nominee)
*
The nominee confirms their intention to accept a position on the Grant Review Committee and agrees to the time commitment as specified in the call for nominations.
Submit
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